Department of Pediatric Psychology and Social Work, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.
Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands; Department of Child Neurology, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands.
Epilepsy Behav. 2018 Dec;89:15-22. doi: 10.1016/j.yebeh.2018.09.038. Epub 2018 Oct 26.
The objective of this study was to explore whether parents experience problems in their own psychological wellbeing and their family functioning two to four years after their child's epilepsy surgery and whether these problems are associated with epilepsy variables, demographic and cognitive variables, and parent-observed behavior problems of the child.
Of the 65 approached families, parents of 31 children participated by completing the Brief Symptom Inventory (BSI), the Family Questionnaire, and the Child Behavior Checklist (CBCL). High scores indicating clinically relevant problems were reported and called 'problem scores'. Correlations between results of questionnaires and demographic and illness variables (abstracted from medical files) were computed for fathers and mothers separately. By comparing the group with at least one problem score with the group without problem scores, risk factors for parent-perceived problems in their own psychological functioning and in family functioning were explored.
Thirty percent of the mothers had problem scores on hostility and on communication within their family. Only a few fathers obtained problem scores, most of these pertaining to their family's organization. Not one parent had a problem score regarding their partner relationship. Many parents had problem scores on behavior problems in their child. Brain area of surgery was the only epilepsy variable related to parents' wellbeing and family functioning, with lowest problem scores for the hemispherotomy group. Scores on behavior problems in the child were also lowest for children after hemispherotomy and for those who had achieved freedom of seizures and antiepileptic drugs (AEDs). Fathers of older children experienced more problems than those of young children.
Parent's wellbeing and family functioning cannot be understood from epilepsy or epilepsy surgery variables only but are related to the child's age and behavior. Having epilepsy is associated with emotional and behavior problems and limits children in developing age-appropriate self-dependence. These problems are not resolved after achieving seizure freedom and have great influence on the family. Professionals should set realistic expectations of epilepsy surgery and should assess, acknowledge, and follow up problems of parental psychological wellbeing and family functioning, regardless of the outcome.
本研究旨在探讨儿童癫痫手术后 2-4 年后,父母自身心理健康和家庭功能是否会出现问题,以及这些问题是否与癫痫相关变量、人口统计学和认知变量以及父母观察到的孩子行为问题有关。
在 65 个被接触的家庭中,有 31 个孩子的父母通过填写简明症状量表(BSI)、家庭问卷和儿童行为检查表(CBCL)参与了研究。报告了高分表明存在临床相关问题,并称为“问题得分”。分别为父亲和母亲计算了问卷结果与人口统计学和疾病变量(从病历中提取)之间的相关性。通过将至少有一个问题得分的组与没有问题得分的组进行比较,探讨了父母自身心理功能和家庭功能感知问题的危险因素。
30%的母亲在家庭内部存在敌对和沟通问题。只有少数父亲获得了问题得分,其中大部分与家庭组织有关。没有一个父母在伴侣关系方面存在问题得分。许多父母的孩子存在行为问题。手术脑区是唯一与父母幸福感和家庭功能相关的癫痫变量,半球切除术组的问题得分最低。手术后孩子的行为问题得分也最低,对于那些已经实现无癫痫发作和无抗癫痫药物(AEDs)的孩子也是如此。年龄较大的孩子的父亲比年龄较小的孩子的父亲经历更多的问题。
父母的幸福感和家庭功能不能仅从癫痫或癫痫手术变量来理解,而是与孩子的年龄和行为有关。患有癫痫会导致情绪和行为问题,并限制孩子发展适合年龄的独立性。这些问题在实现无癫痫发作后并未得到解决,对家庭有很大影响。专业人员应该对癫痫手术的结果设定现实的期望,并评估、承认和跟进父母心理健康和家庭功能的问题,无论结果如何。